The purpose of this program is to enhance the adjustment and quality of life in adolescents with systemic lupus erythematosus (SLE). The theoretical rationale is based on the Investigators' program of research in the validation of models in pediatric psychology designed to predict adjustment and adaptation in children and adolescents with chronic illness. To accomplish this purpose, the first aim of the investigation is to assess the associations between adaptational processes and adjustment and health-related quality of life in female adolescents with SLE. A major hypothesis of the study aim is that adaptational processes including methods of coping, expectations of self-efficacy, and social support will account for a significant proportion of the variance in adjustment and health-related quality of life after controlling for demographic characteristics and disease parameters. It also is hypothesized that methods of coping, expectations of self-efficacy, and social support will independently mediate the association between severity of disease and adjustment and health-related quality of life. The second aim of the investigation is to conduct a controlled randomized manualized-based trial designed to enhance adjustment and quality of life in female adolescents with SLE. The hypothesis of the study aim is that the manualized-based cognitive-behavioral intervention will lead to improvements on measures of adjustment and quality of life in comparison to an education-only control group and a no-contact control group. Finally, it is hypothesized that the benefits of the manualized intervention will persist over a six-month follow-up period. To accomplish the objectives of this program of research, female adolescents diagnosed with SLE ranging in age from 12 to 18 years, the majority of whom are African-American, will serve as participants. Data to bc obtained from the participants will include periodic assessments of pain, methods of coping, expectations of efficacy, social support, negative affecxtivity, perceptions of physical appearance, social competence, and health-related quality of life. In addition, caregivers and teachers also will report on the adolescents' general adjustment, while physicians will complete measures of disease severity. It is anticipated that the 147 patients will be randomized to the three arms of the intervention trial. The research study proposed here will add to the extant literature by validating mediational processes of adjustment and quality of life in adolescents with SLE and will also validate empirically a cognitive behavioral therapy intervention program that has been demonstrated in other research to alter maladaptive cognitions and increase the use of selective coping skills, thereby enhancing adjustment and quality of life for individuals with a chronic disease.